Re: Interesting term
Jim DeWees
Description
Collection
Title:
Re: Interesting term
Creator:
Jim DeWees
Date:
10/4/2007
Text:
Regarding this article and the insurance company listed here, I wanted to ad
me own personal experience with them.
I was searching for an individual policy almost 2 years ago (Feb 2006), and
after contacting an insurance broker, he came to my office explaining the
policy and benefits for the same insurance that is the topic of the article
of this boy and the wheelchair.
I disclosed the fact that I am a below knee amputee. I have always had
insurance, I have never let it lapse of gone without it, regardless of my
own personal financial state, insurance is a necessity to me.
After all the sales pitch and filling out the forms, giving them a voided
check for automatice withdrawl, etc. I got the policy to review and sign. I
noticed there was a rider attached to the policy, which had a 10 year
exclusion for anything related to my left leg. They would not provide any
prosthetics or any services associated with my leg. I questioned them about
this issue, asking them if it is legal to do that, since I have credible
coverage and have always had coverage. They said it was an oversight and
they would remove the rider. They sent me a new policy with a piece of
paper attached to it stating it BOLD letters that the rider was removed from
the policy, and in small, fine print it said Effective February 2016. I
caught that small print, called them on it again, and told them that I was
NOT interested in their insurance and would make sure that I spread the
word about them to my patients or anyone else that I have a chance to talk
to.
They were very slick in their sales tactics and almost caught me in their
web. It does not at all suprise me that they are in the news like this.
On a positive note, after I was in the paper about my dispute with my
insurance company, I was contacted by an insurance agent that told me about
another option for me, and also for my new son Cameron. They quoted me the
rates with a company called Consumer's Life, which uses the IHN network
(Indiana Health Network) for services inside the state. Out of state
services use the PHCN network (Private Healthcare). I called my
pediatrician and asked that office what they prefer...my current insurance
or the new one with IHN. They said that IHN is MUCH better, easier to work
with, and pays them considerably more for the same services. I called my
primary care physician and aksed the same thing, and got the same response.
The new insurance is almost $200 less each month, and has lower deductibles,
better coverage, cheaper prescription drug coverage, etc. It is a win-win
situation. I told the person at the IHN consumer line, and told her that it
is amazing that it is cheaper, and yet pays the providers more than the
other company. Her comment was something to the effect that they can do
that because they don't have a CEO getting a $50 million bonus each year. I
told her how much I agreed with that comment.
If any of you are in the process of choosing an insurance policy, you need
to look at who treats us well, pays us decently for our services, and
support these companies. At least that is a start. The only way these
insurance companies are going to change is when they see things going down
hill for them. When they start seeing a loss of subscribers and loss of
business they might start worrying and changing their actions and the way
they treat the providers and subscribers.
Again, these are just my ideas about insurance companies and how I feel
about what is going on.
Take care,
Jim DeWees, CP
>From: Wil Haines < <Email Address Redacted> >
>Reply-To: <Email Address Redacted>
>To: <Email Address Redacted>
>Subject: [OANDP-L] Interesting term
>Date: Wed, 3 Oct 2007 23:37:33 -0400
>
>Hello colleagues and guests:
>
>Thanks to Nancy VanMeter's post today, I was introduced to a new and, I
>believe, important term: Falsely Insured. I love this term because it
>exposes the underhanded tactics that are being used by some insurance
>companies to deny claims for legitimate medical devices. I believe falsely
>insured is a term that will have great significance in the future in the
>battle for medical parity.
>
>Here's the link: <URL Redacted>
>
>You be the judge.
>
>Wil Haines, CPO
>MaxCare Bionics
>Indianapolis, IN
>
>
me own personal experience with them.
I was searching for an individual policy almost 2 years ago (Feb 2006), and
after contacting an insurance broker, he came to my office explaining the
policy and benefits for the same insurance that is the topic of the article
of this boy and the wheelchair.
I disclosed the fact that I am a below knee amputee. I have always had
insurance, I have never let it lapse of gone without it, regardless of my
own personal financial state, insurance is a necessity to me.
After all the sales pitch and filling out the forms, giving them a voided
check for automatice withdrawl, etc. I got the policy to review and sign. I
noticed there was a rider attached to the policy, which had a 10 year
exclusion for anything related to my left leg. They would not provide any
prosthetics or any services associated with my leg. I questioned them about
this issue, asking them if it is legal to do that, since I have credible
coverage and have always had coverage. They said it was an oversight and
they would remove the rider. They sent me a new policy with a piece of
paper attached to it stating it BOLD letters that the rider was removed from
the policy, and in small, fine print it said Effective February 2016. I
caught that small print, called them on it again, and told them that I was
NOT interested in their insurance and would make sure that I spread the
word about them to my patients or anyone else that I have a chance to talk
to.
They were very slick in their sales tactics and almost caught me in their
web. It does not at all suprise me that they are in the news like this.
On a positive note, after I was in the paper about my dispute with my
insurance company, I was contacted by an insurance agent that told me about
another option for me, and also for my new son Cameron. They quoted me the
rates with a company called Consumer's Life, which uses the IHN network
(Indiana Health Network) for services inside the state. Out of state
services use the PHCN network (Private Healthcare). I called my
pediatrician and asked that office what they prefer...my current insurance
or the new one with IHN. They said that IHN is MUCH better, easier to work
with, and pays them considerably more for the same services. I called my
primary care physician and aksed the same thing, and got the same response.
The new insurance is almost $200 less each month, and has lower deductibles,
better coverage, cheaper prescription drug coverage, etc. It is a win-win
situation. I told the person at the IHN consumer line, and told her that it
is amazing that it is cheaper, and yet pays the providers more than the
other company. Her comment was something to the effect that they can do
that because they don't have a CEO getting a $50 million bonus each year. I
told her how much I agreed with that comment.
If any of you are in the process of choosing an insurance policy, you need
to look at who treats us well, pays us decently for our services, and
support these companies. At least that is a start. The only way these
insurance companies are going to change is when they see things going down
hill for them. When they start seeing a loss of subscribers and loss of
business they might start worrying and changing their actions and the way
they treat the providers and subscribers.
Again, these are just my ideas about insurance companies and how I feel
about what is going on.
Take care,
Jim DeWees, CP
>From: Wil Haines < <Email Address Redacted> >
>Reply-To: <Email Address Redacted>
>To: <Email Address Redacted>
>Subject: [OANDP-L] Interesting term
>Date: Wed, 3 Oct 2007 23:37:33 -0400
>
>Hello colleagues and guests:
>
>Thanks to Nancy VanMeter's post today, I was introduced to a new and, I
>believe, important term: Falsely Insured. I love this term because it
>exposes the underhanded tactics that are being used by some insurance
>companies to deny claims for legitimate medical devices. I believe falsely
>insured is a term that will have great significance in the future in the
>battle for medical parity.
>
>Here's the link: <URL Redacted>
>
>You be the judge.
>
>Wil Haines, CPO
>MaxCare Bionics
>Indianapolis, IN
>
>
Citation
Jim DeWees, “Re: Interesting term,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/228660.
